Other

Question 1

Motor Control involves:

a. The concept of stability and mobility
b. Agonist and antagonist muscles
c. Balance
d. Control of both movement and posture
e. All of the above

Answer 1

e. All of the above

Question 2

Voluntary muscle activity can be influenced by:

a. emotional state
b. temperature
c. presence of another person in the room
d. all of the above
e. a and b only

Answer 2

d. all of the above

Question 3

The primary purpose of measuring range of motion for the OT is to:

a. correct deformity
b. stretch tight tissues
c. monitor effects of medications
d. analyze identified limitations to occupations
e. ensure normal UE range of motion

Answer 3

d. analyze identified limitations to occupations

It is not essential to be concerned unless range affects occupation. The physician analyzes medication intake. You can’t ensure normal UE range of motion. If you think could cause problems down the road, collaborate with PT

Question 4

Marilyn was referred to OT in an outpatient clinic following a wrist fracture, which is now stable. Following the occupational history, the therapist observed Marilyn’s ability to perform aspects of her upper body dressing medication management. Marilyn exhibited difficulty opening her pill bottles. The OT decided to next do an AROM scan. The primary purpose of the AROM scan is to:
A. Evaluate her UE coordination
B. Quickly identify possible ROM limitations
C. See how well Marilyn can follow directions
D. Find out if her wrist is still painful
E. Quickly screen Marilyn’s vision and perception

Answer 4

B. Quickly identify possible ROM limitations

After this, assess PROM if limitations exist

Question 5

While Performing an AROM scan, the OT notices that Marilyn is unable to flex her elbow fully. Based on this observation, the therapist should next…
A. Document this. No further assessment is necessary
B. Perform Manual Muscle Testing
C. Measure AROM
D. Attempt to passively move her elbow through complete elbow flexion

Answer 5

D. Attempt to passively move her elbow through complete elbow flexion

Question 6

When performing sensory testing, the primary reason to occlude the client’s vision is that…

Answer 6

people often use vision to compensate for sensory impairments. Visual input helps the client to process tactile sensory info because that is how they compensate (does not distract them)

Question 7

You are completing an OT eval on Janet, who underwent a laminectomy and excision (removal) of a spinal cord tumor at the cervical level. Which of the following describes an accurate representation of your expectations regarding Jane’s sensation?
A. Peripheral nerve distributions
B. Sensory impairments contralateral to lesion
C. Sensory impairments that follow dermatomal distributions
D. Affects dermatomes on one side of the body

Answer 7

C. Sensory impairments that follow dermatomal distributions (for spinal cord)
Peripheral nerve distributions is for peripheral nerve injuries; Sensory impairments contralateral to lesion on hemiplegic side if for Stroke/TBI; Peripheral Nerve Injury at the Peripheral Nerve root affects dermatomes on onse side of the body

Question 8

When performing an assessment of edema on a client with swelling in BOTH upper extremities, the therapist should
A. Assess edema in one UE using a volumeter or circumferential measurement
B. Assess edema in both UE using a volumeter or circumferential measurement
C. Use initial edema measurements as a baseline to determine effects of subsequent intervention
D. B and C

Answer 8

D. The therapist should assess edema in both UE using a volumeter or circumferential measurement and use the initial edema measurements as a baseline to determine the effects of subsequent intervention

Question 9

You are evaluating Hazel, a 73-year old female admitted to an inpatient rehab until following a right CVA. Following completion of occupational history and profile, you observe her ablity to perform some of the self-care tasks she must be able to do at home since she lives alone--toileting and dressing. You notice motor impairments on her left side, both LE and UE, as well as a tendency to neglect her left arm in tasks. Based upon observations, you would next complete:
A. A PROM assessment
B. MMT
C. AROM scan
D. AROM measurement

Answer 9

C. AROM scan. It may not be necessary to move hands over head for toileting and dressing. Between AROM scan and MMT, there is a PROM assessment. You need to know parameters of testing/available range before you can move to MMT.

Question 10

While performing an ROM scan of Hazel’s left UE you notice limitations. Your next step would be:
A. Perform MMT of Hazel’s left UE
B. Perform a PROM assessment of Hazel’s left UE
C. Finalize an intervention plan

Answer 10

B. Perform a PROM assessment of Hazel’s left UE

Question 11

Hazel was admitted to an inpatient rehab following a right CVA. You have already noticed impairments in her LE and UE and completed an AROM scan and PROM assessment of her left UE. You complete an observational assessment of Hazel’s motor control. You would begin this assessment by looking at:
A. Muscle Tone
B. Voluntary muscle activity qualitatively to find typical and missing movement components
C. Functional use of the UE
D. Alignment in sitting and her trunk position and motoin

Answer 11

D. First look at Hazel’s alignment in sitting and her trunk position and motion. One can only get the full available ROM if they are sitting upright in an anterior pelvic tilt with feet flat on the floor. Look at alignment and ability to maintain alignment. Then, you would look at muscle tone (high enough to resist gravity, low enough to allow for movement). Next, you would assess voluntary muscle activity qualitatively (observe typical and missing movement components. Then assess functional use of theUE (no movement vs. spontaneous use, attempts at voluntary use, performance skills)

Question 12

The ability to select a favorite pen inside one's backpack pocket without looking (using hand):
A. Proprioception
B. Pain awareness
C. Stereognosis
D. Light touch/localization

Answer 12

C. Stereognosis

Question 13

The ability to describe whether a body part is being moved up or down with vision occluded:
A. Stereognosis
B. Proprioception
C. Pain Awareness
D. Light touch/Localization

Answer 13

B, proprioception

Question 14

Recognizing that the femur was fractured during lower body dressing:
A. Proprioception
B. Pain awareness
C. Light touch/localization
D. Stereognosis

Answer 14

B. Pain awareness

Question 15

The ability to detect an ant crawling on one's arm (pointing where the arm is):
A. Stereognosis
B. Pain Awareness
C. Proprioception
D. Light touch/Localization

Answer 15

D. Light touch/localization

Question 16

Assuming client exhibits signs of weakness, what type of muscle strength test would you do for a client with osteoarthritis with precautions against applying resistance?
A. MMT: individual muscles
B. Functional strength test
C. MMT: muscle groups

Answer 16

Functional strength test. Do a functional assessment if there are precautions against applying resistance

Question 17

Assuming client exhibits signs of weakness, what type of muscle strength test would you do for a client with incomplete spinal cord injury C6-C7?
A. MMT: individual muscles
B. Functional strength test
C. MMT: muscle groups

Answer 17

A. MMT individual muscles. You need to know what is working and what is not working.

Question 18

Assuming client exhibits signs of weakness, what type of muscle strength test would you do for a client with rheumatoid arthritis without precautions:
A. MMT: individual muscles
B. Functional strength test
C. MMT: muscle groups

Answer 18

C. MMT muscle groups
if you see there are no precautions, you want to get the most information you can get (group muscles gives you more info than functional). Most people are prone to having pain/inflammation

Question 19

Assuming client exhibits signs of weakness, what type of muscle strength test would you do for a client with radial nerve compression injury (PNI):
A. MMT: individual muscles
B. Functional strength test
C. MMT muscle groups

Answer 19

A. MMT individual muscles

Question 20

Assuming client exhibits signs of weakness, what type of muscle strength test would you do for a client with UE burns without precautions:
A. MMT individual muscles
B. Functional strength test
C. MMT muscle groups

Answer 20

C. MMT muscle groups

Question 21

Assuming client exhibits signs of weakness, what type of muscle strength test would you do for a client with a spinal cord injury at T-10:
A. MMT individual muscles
B. Functional strength test
C. MMT muscle groups

Answer 21

C. MMT muscle groups. Level T-10 are completely fine in UE; arms are not impaired at the T-10 level. Should keep in mind the level of spinal injury.

Question 22

Which statement below best describes Susan's functional limitations when she attempts to pick up a full mug of coffee with her dominant hand? 
Deltoid: normal (N or 5)
Wrist extensors: poor minus (P- or 2-)
Biceps: normal (N or 5)
Finger flexors: Fair+ (F+ or 3+)

A. Susan would have no problem picking up a full mug of coffee with her dominant hand
B. Susan’s grasp force would be limited, resulting in decreased capacity to hold onto a mug
C. Susan would not be able to pick up the mug at all with her dominant hand
D. Susan would have a hard time picking up the mug at first but would be able to sustain the grasp force necessary to hold it

Answer 22

B. Susan’s grasp force would be limited, resulting in decreased capacity to hold onto a mug

Question 23

Enrique is a 17 year old male who sustained a C-5 complete spinal injury. To assess strength of elbow muscles, you perform a special MMT. During MMT, resistance should be applied:
A. At the end of Enrique’s elbow flexion range
B. At the mid point of Enrique’s elbow flexion range
C. At the beginning of Enrique’s elbow flexion range
D. At any of the above

Answer 23

A. Resistance at the end of Enrique’s elbow flexion range creates good interrater reliability from person to person and tester to tester. However, there are 2 tests that are not not at the end range: shoulder flexion and abduction (at 90 degrees midpoint)

Question 24

Analyze the following clinical picture by looking at passive and active ROM provided:
Finger flexion: 0-110 degrees (normal ROM)
Passive ROM: 0-70 degrees
Active ROM: 0-0 degrees, gravity eliminated
Based upon the above documentation, you will score client’s finger PIP muscle strength as

Answer 24

Trace or Zero (1 or 0).
Don’t cross joints when applying resistance during MMT. If you’re testing shoulder , don’t cross elbow. If you’re testing elbow, don’t cross wrist.
3-: only can get through part of your available range against gravity; can’t get through full available range against gravity
3+=functional
3 or higher=against gravity
below 3, you have to go into gravity eliminated
*note if you are not able to get a client into anti-gravity

Question 25

T/F: When performing sensory tests, OT typically tests “involved” (affected) UE first to get a clear picture of client’s deficits

Answer 25

False

Question 26

T/F: A figure-of-eight measurement is a circumferential measurement of edema that is useful for individuals who are unable to submerge the hand in water, and correlates well with volumetric testing

Answer 26

True

Question 27

T/F: When holding dynamometer, pt should be at 90 degrees of elbow flexion and shoulder adduction, forearm in neutral, slight wrist extension and ulnar deviation; optimal length tension relationship in wrist

Answer 27

True

Question 28

Abnormal sensation e.g., animals crawling, pain in the RUE, awareness of midline in sitting, no double or blurry vision, and auditory are all observations under which category:
A. Motor and Praxis skills
B. Sensory perceptual skills
C. Emotional Regulation Skills
D. Cognitive Skills
E. Communication and social skills

Answer 28

B. Sensory perceptual skills

Question 29

Able to voluntarily move RUE, no gesturing with RUE, able to roll to right and grasp bed rail, maintains alignment in sitting, slower movement in RUE, able to grasp/release object, balance impairments, Functional use of RUE when dressing, stiff and slow RUE movements, decrease fine motor skills, incoordination, neglect RUE. These are all observations dealing with...
A. Communication and social skills
B. Cognitive Skills
C. Emotional Regulation Skills
D. Sensory perceptual skills
E. Motor and Praxis Skills

Answer 29

E. Motor and Praxis Skills

Question 30

Which of the following should be done first:
A. Gross manual muscle test
B. UE coordination/hand function
C. Visual Foundation Skills
E. AROM scan and ROM as indicated

Answer 30

E. AROM scan and ROM indicated. Qualitative assessment of pain as well (can be assessed at any point)

Question 31

In what order would you perform the following assessments:
AROM scan and ROM, UE coordination/hand function, UE sensation, visual foundation skills, Assessment of motor control, Cognition/cognitive foundation skills, visual foundation skills

Answer 31

1. AROM Scan and ROM
2. Gross Manual Muscle Test (assuming selective control)
3. Assessment of Motor Control (alignment and foundations, tone, voluntary movement, functional use)
   (2 and 3 may occur in either order)
4. UE coordination/hand function
5. UE Sensation: light touch/localization, sharp/dull, proprioception/kinesthesia, stereognosis; possibly two-point discrimination and touch pressure threshold
   (4 and 5 may occur in either order)
6. Visual Foundation Skills (will screen throughout but formal assessment typically follows other areas)
7. Cognition/Cognitive foundation skills (will screen throughout but formal assessment typically follows other areas)
   (6 and 7) may occur in either order)